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Evaluating Quality of Life and Pulmonary Function of Long-term Survivors of Non-Small Cell Lung Cancer Treated With Radical or Postoperative Radiotherapy

Ozturk, Aysen, MD*; Sarihan, Sureyya, MD; Ercan, Ilker, PhD; Karadag, Mehmet, MD§

American Journal of Clinical Oncology: February 2009 - Volume 32 - Issue 1 - p 65-72
doi: 10.1097/COC.0b013e31817e6ec2
Original Article: Thoracic
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Background: Our aim in the present study was to describe the quality of life (QOL), evaluate pulmonary function, and compare demographic and clinical characteristics with QOL in long-term survivors of non-small cell lung cancer treated with radical or postoperative radiotherapy.

Methods: Twenty-eight patients were recruited in the study. QOL was evaluated using The European Organization for Research and Treatment of Cancer, Quality of Life Core Questionnaire (EORTC QLQ-C30, v.3). Statistical analysis was performed by SPSS 14.

Results: Patients' files were reviewed in October 2006. Median duration of follow-up was 46 months (range: 25–125 months). Seven of 9 scales were found to meet the minimal reliability limit (Cronbach's α >0.70). The lowest and highest reliability coefficients were 0.56 and 0.93 for social and role functioning, respectively. All interscale correlations were statistically significant (P < 0.01). The strongest positive correlation was found between physical functioning and, role and cognitive functioning (r = 0.59, r = 0.37 or P = 0.01, P = 0.05, respectively). The highest correlation of EORTC QLQ-C30 and the Karnofsky performance scale (KPS) during the questionnaire was found to be with physical functioning and constipation (r = 0.41, r = 0.44 or P = 0.02, P = 0.01, respectively). When the effect of various demographic and clinical parameters on QOL was evaluated; initial KPS, age, educational level, health insurance status, stage, chemotherapy, comorbid disease, and passive smoking were determined as significant factors influencing QOL. Physical, role, cognitive, and emotional functions were found to be significantly lower in the presence of dyspnea (r = 0.42, r = 0.58, r = 0.50, r = 0.63 or P = 0.02, P < 0.01, P < 0.01, P < 0.05, respectively). Regarding the symptom scales, dyspnea was found to be correlated with increasing of fatigue, pain, insomnia, and appetite loss (r = 0.52, r = 0.40, r = 0.64, r = 0.38 or P < 0.01, P = 0.03, P < 0.05, P = 0.04, respectively). The parameters of pulmonary function tests (FEV1, FVC, and FEV1/FVC) did not show any significant relation with any scale of QOL.

Conclusion: Overall, we found that QOL of our patients who survived at least 2 years after radiotherapy, was good. The Turkish version of the EORTC QLQ-C30, v.3 is a valid and reliable instrument for Turkish lung cancer patients and can be used in clinical studies. We believe further studies are needed to have a better understanding of patients' pretreatment and posttreatment QOLs.

From the *AOS Oncology Hospital; Departments of †Radiation Oncology, ‡Biostatistics, and §Chest Diseases, Faculty of Medicine, Uludag University, Bursa, Turkey.

Reprints: Sureyya Sarihan, MD, Department of Radiation Oncology, Faculty of Medicine, Uludag University, 16059 Bursa, Turkey. E-mail: azsarihan@superposta.com.

© 2009 Lippincott Williams & Wilkins, Inc.